Common Contracts
2 similar Participating Provider Agreement contracts
ADDRESS Group NPI number: ADDRESS Dear Healthcare Provider: CONTRACT ENCLOSEDParticipating Provider Agreement • August 7th, 2020
Enclosed please find a copy of the Highmark Professional Provider Agreement (“Commercial Agreement”). Please execute and return the Commercial Agreement in order for Highmark to finalize execution of this document. Upon finalization of your Commercial Agreement, you will receive a fully executed copy of the Commercial Agreement with an acknowledgment for your files. In addition, a Welcome Letter announcing your Highmark Commercial Agreement effective date(s), Group Provider Number and Managed Care Vendor Number will be returned to you for your files. Please note that new applicants should not see members or submit claims until notified that they have been accepted in the network via a Welcome Letter.
Participating Provider AgreementParticipating Provider Agreement • May 17th, 2018
Participating Provider, by its signature on the execution page of the Highmark Inc. d/b/a Highmark Blue Shield Participating Provider Agreement to which this Cover Page is attached, hereby certifies that the information provided in the foregoing Listing of Practitioners as prepared by Highmark Inc. d/b/a Highmark Blue Shield is accurate, true and correct. Participating Provider further understands and agrees that if it and its Practitioners are accepted as Participating Providers, participation will be governed by the terms and conditions of the Highmark Inc. d/b/a Highmark Blue Shield Participating Provider Agreement attached hereto as if all are a party thereto and the accompanying Regulations to such Participating Provider Agreement.
